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COUNTRYSIDE MANOR, INC

Assisted Living Facility

Stokesdale, North Carolina

Provider NPI: 1992790810

Organization Information:
Organization Name:  COUNTRYSIDE MANOR, INC


Practice Location:
7700 US HIGHWAY 158  STOKESDALE, NC 27357 US
Tel: 336-643-6301  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X310400000XNursing & Custodial Care Facilities
Assisted Living Facility
NCNH0226
X313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
NCNH0226
X314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility
NCNH0226

Other Provider Identifiers:

IssuerNumberStateType
3416145NC05
3415390NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ASSISTED LIVING JOBS NC - Page 1



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